Five Utah nursing homes are potentially at risk of losing Medicaid eligibility — and funding — including one Ogden facility that federal administrators say has failed to make improvement since being identified as having “a history of serious quality issues.”
A U.S. Senate report released this week includes a list of 400 nursing homes nationwide that are either designated by the Centers for Medicare and Medicaid Services (CMS) as a Special Focus Facility, or SFF, or as a candidate for that designation. SFF denotes facilities that “substantially fail” to meet standards of required care.
“Many documented cases of abuse and neglect occur in facilities affiliated with the federal Special Focus Facility (SFF) program,” the report states. “The SFF program is designed to increase oversight of facilities that persistently underperform in required inspections conducted by state survey agencies.”
In Utah, Ogden’s Lomond Peak Nursing and Rehabilitation is designated as an SFF facility, while the other four Utah locations named in the Senate report are candidates for the SFF designation. Those four facilities include Salt Lake City’s Pine Creek Rehabilitation and Nursing, West Valley City’s Rocky Mountain Care – Hunter Hollow, West Jordan’s Copper Ridge Heath Care and South Ogden’s Mountain View Health Services.
Joel Hoffman, director of the Utah Department of Health’s Bureau of Licensing and Certification, said facility surveys are completed on a roughly annual basis, with the worst-performing locations identified as SFF and SFF candidates. But while that process always results in lower- and higher-scoring nursing homes, he said, the surveys do identify local poor-performing locations.
“If it was me, or a loved one of mine, in a facility and I saw this list and they were in one of these facilities,” he said, “I would want to probably contact us at the [health] department and find out why.”
Representatives for the five Utah nursing homes listed in the report either did not respond to requests for comment, or could not be reached.
A CMS listing of SFF facilities, last updated in May, states that Lomond Peak had its most recent survey in March and that the facility had not improved in the six months since its SFF designation. Nursing homes added to the SFF program are expected to improve and “graduate” within 18-24 months of their designation, the report states, or face termination from federal health care programs or be allowed a time extension if there has been “very promising progress.”
Nursing homes in the SFF programs are also subject to more frequent inspection by administrators. No additional information was provided in the Senate report regarding the Utah facilities, but CMS documents state that SFF is intended to address nursing homes with more frequent and more serious problems, including harm or injury experienced by residents.
“When deficiencies are identified, we require that the problems be corrected,” the report states. “If serious problems are not corrected, we may terminate the nursing home’s participation in Medicare and Medicaid.”
Hoffman said serious deficiencies include real or potential harm to residents, like delayed test results and medication, insufficient staffing or hazards like unsafe water temperatures.
The four candidate facilities will continue to be inspected on an annual basis, he said, but would face the increased scrutiny of the SFF designation if their performance does not improve.
“Hopefully they’re noticing that and working hard to alleviate those lower scores,” he said.
Hoffman also said that while some residents’ costs are paid privately or through the U.S. Department of Veterans Affairs, the bulk of Utah nursing home revenue comes from Medicaid and Medicare recipients. And termination from those programs, Hoffman said, would likely coincide with decertification by the Utah Department of Health.
“In Utah, it probably would shut them down," he said.